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Kids in Crisis: Lack of placement options afflicts juvenile system
The Record-Eagle - 10/2/2022
Oct. 2—CHEBOYGAN — Connor spent weeks in a windowless emergency room.
He wasn't physically ill or injured; he was just waiting for help.
Connor, 17, had a run-in with police in Cheboygan in May after threatening to harm himself, and a court ordered him to check in to a long-term care facility that would help him manage his mental health diagnoses.
His mother, Carrie, hoped sending her son to a long-term care facility would help him get back on track before he turned 18, when he would no longer be considered a juvenile.
"Basically there was a list of things for Connor and, to support me, that the court said, 'You need to do this,'" Carrie said.
He was lodged at McLaren Northern Michigan hospital in Petoskey to wait until a youth mental health bed opened up at one of Michigan's 14 facilities.
Carrie, a single mother who works full-time and has other children, drove the 45 minutes from her home in Cheboygan nearly every day.
No facility had the space.
Weeks went by.
No one would take the boy for his delinquent history or mental health diagnoses.
"It was traumatizing to Connor and my whole family," Carrie said. "And it was detrimental to his mental health."
Carrie said the hospital staff treated her son well and his behavior steadily improved. But she knew he needed the extra attention from a residential care facility.
The room he was in was small with no windows. Carrie said Connor rarely got to go outside.
Those types of rooms are standard in ER spaces so a patient can't harm themselves or others. But Tressa Gardner, executive director of emergency services for McLaren Health Care system, said they aren't meant to be used for long stays.
"When you don't have that next step for them to go to a psychiatric facility, and they're not safe to go home, this is where they're housed," she said. "It's not the hospital's fault. It's not the parent's fault. It's not the ER staff's fault. It's the fact that we do not have enough beds in the state to accommodate these children."
Connor's stay happened in springtime — between May 9 and June 17. It's October now and Carrie's son still hasn't been admitted to a facility with open youth mental health beds.
She's not alone. The critical shortage of places to put young people in the juvenile justice system is a crisis that's impacting families all over the state.
Officials from local Michigan courts agree that little about Connor's story is unique.
The top priority for the juvenile justice system is rehabilitation, said Midland County Probate Court Judge Dorene Allen. Oftentimes, seeking mental health care is the most important step in the process.
But since before the pandemic, Michigan has been dealing with a statewide shortage of beds in both short-term detention centers and long-term care facilities — leading kids like Carrie's son to being trapped in place.
"It's horrible," Allen said. "It's a horribly necessary problem to solve."
Allen serves on the Michigan Probate Judges Association, which passed a resolution in July declaring the shortages a crisis and imploring the state to take action.
The document mentions stories similar to Connor's — from different counties across Michigan.
One boy, called Z.R. to protect his identity, waited in a hospital for 28 days until placement was secured.
A girl named K.D. was removed from an abusive home and slept on an air mattress in a courthouse until authorities could send her somewhere else.
According to MPJA, virtually every county in the state has faced a lack of available placements for juveniles — but, in rural northern Michigan, the distance between communities and resources make the problem even worse.
Data from the Michigan Department of Health and Human Services shows there are 276 general inpatient psychiatric beds in the state. About half are concentrated in the southeast region and Metro Detroit area.
The data shows there are six beds in the entire northern Lower Michigan and the Upper Peninsula — and all are located in Marquette.
"I've met with parents whose jobs are actually on the line because they have to get their youth to other counties during the day once a week," Antrim County family court administrator Teresa Ankney said. "It's extremely unfortunate in so many ways. These families want help for their kids. The whole community does."
The crisis comes at a time when more kids across the country are struggling with mental illness. Twenty percent are living with a diagnosable mental illness and 10 percent are experiencing a significant impairment, according to a 2021 report from the Citizens Research Council of Michigan.
Add to this the national health care professional shortage that still plagues Michigan hospitals and that results in what Gardner calls "a very big fundamental problem."
"I've been practicing emergency medicine for 27 years," Gardner said. "This is the toughest time I've ever experienced in my career. And it's, it's all related to our shortages that we have."
At youth detention centers, where young people are placed to await court dates for those who exhibit violent behavior, law enforcement officers have had to take drastic measures.
In Cheboygan for example, police often have to transport detained juveniles to out-of-state detention centers — sometimes just for one night — before they appear in court.
Cheboygan County Sheriff Dale Claremont has said it can cost between $300 and $400 per day to house a juvenile out-of-state, in addition to the cost for transportation, all paid for with taxpayer dollars.
Carrie said she's lucky that wasn't the case for her son the night he was detained — but what came after that was much worse, she said.
Her son's lawyer, James Gilbert, has a multiple-page spreadsheet of all the residential care facilities that denied his admittance for one reason or another. The most common reason was that they were already full, or not equipped to take more patients. Other reasons had to do with the boy's history, Gilbert said.
Private mental health facilities have full discretion to decide which patients should be admitted. Gilbert said he expects many of them didn't want to take a risk.
"We were all feeling pretty helpless," Gilbert said. "He's 6-foot-4 [inches tall], 240 pounds. I think if he was an 80-pound little girl, timid and shy, they would have had a bed."
After her son spent those six weeks in the emergency room, Carrie said she'd had enough.
She decided the best option was to bring him back home and enroll him in community mental health therapy despite having a court-appointed plan for a long-term facility.
She said she couldn't watch her son suffer any longer in that emergency room. Since then, she said her son has been doing better in the care of CMH, but Carrie's faith in the juvenile justice system is draining away.
"Does anybody care?" she asked. "People that have never had a kid with disabilities have no idea. They don't know because their lives can go on."
None of the dysfunction is a secret.
Work is being done, from the county to the state level, to overhaul the system. A juvenile justice task force appointed by Gov. Gretchen Whitmer released its recommendations earlier this summer after nine months of deliberation.
One of its more striking findings is that there is no consistent data collection about kids who end up in the system — meaning, there is no way of knowing how many kids are out there in similar situations like Carrie's family.
Read more about the problems with Michigan's juvenile justice system and what's being done to address them in next Sunday's Record-Eagle. This story also will be presented Monday on Interlochen Public Radio.
Editor's note: Because of the sensitive nature of protecting juvenile offenders and their families, only first names are being used for certain sources.
If you have an experience with the juvenile justice system to share, please contact reporters Elizabeth Brewer (firstname.lastname@example.org) and Michael Livingston (email@example.com).
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